Health Psychology and Behavioral Medicine最新文献

Introduction: This study examined the training effects of an online game-based cognitive bias modification for interpretation (CBM-I) program in reducing fear during the COVID-19 pandemic in Hong Kong. In addition to investigating the changes in both proximal (i.e. negative and positive interpretations) and distal outcomes (i.e. fear of COVID-19), we examined whether individuals with higher baseline resilience levels would benefit more from the CBM-I program.

Methods: A total of 68 Hong Kong undergraduate students were randomized into either the CBM-I group or a control group, among which 66 participants completed the pretest, post-test, and follow-up on negative and positive interpretations, fear of COVID-19, and resilience.

Results: Compared to the control group, the CBM-I training group showed a significantly greater decrease in negative interpretations, a significantly greater increase in positive interpretations of COVID-19-related ambiguous scenarios, and a trend toward a greater reduction in fear of COVID-19. The CBM-I training was more effective at reducing fear among those with higher levels of resilience at baseline, whereas the control group showed the opposite effect, albeit to a lesser extent.

Conclusion: This online game-based CBM-I training shows the potential to modify the negative interpretation bias toward fear-inducing scenarios and contributes to the reduction of fear. Baseline screening of resilient individuals may optimize the training effects.

Background: Hospitalisation can be a traumatic experience, where inpatients are exposed to an abundance of physical and psychological stressors. Evidence suggests that these hospital-related stressors negatively impact health: a phenomenon known as post-hospital syndrome. The current study aimed to identify hospital-related stressors, and to develop and provide initial validation for a new measure of in-hospital stress.

Methods: Measure development occurred in three stages: (i) semi-structured interviews, (ii) item generation, and (iii) pilot testing. Twenty-one patients were interviewed regarding their recent hospital experiences, and a list of hospital-related stressors was produced. These stressors were compiled into a questionnaire and piloted on 200 recent inpatients to provide initial evidence of internal consistency and construct validity.

Results: Stressors identified from the interviews captured all relevant questions from three previous hospital stress measures, plus 12 more. The most reported stressor was 'poor sleep'. These hospital-related stressors were developed into 67 questions, forming the Hospital Stress Questionnaire (HSQ). The HSQ showed excellent internal consistency and construct validity, and correlated with feelings of vulnerability and being unprepared to go home.

Conclusion: The HSQ is a promising self-report tool for measuring in-hospital stress. Future research ought to investigate its psychometric properties further in larger and more diverse samples. The measure has potential to be used to monitor patient risk of post-hospital syndrome.

Background: Few studies have examined how multi-level social factors interact and affect developmental patterns of sexual risk among middle-to-late adolescents who are at risk of experiencing sexual risk behaviors. We examined developmental trajectories of sexual risk behaviors of boys and girls in middle-to-late adolescence and the effects of exposure to three social risk factors (poor parental monitoring, peer risk, and neighborhood risk).

Methods: We followed 2,332 Bahamian adolescents every six months from Grades 10-12. We used group-based trajectory modeling to identify distinct trajectories of sexual risk behaviors for boys and girls.

Results: We identified three trajectories each for boys and girls. Peer risk and neighborhood risk predicted a high sexual-risk trajectory for boys, and peer risk (alone or combined with other risk factors) had the greatest impact on the membership of moderate-to-high-risk trajectory for girls. Parental monitoring had a relatively small effect on adolescents' sexual risk behavior.

Conclusion: Our results underscore the importance of early identification of adolescents with sexual risk behavior and development of targeted prevention interventions to improve adolescent health outcomes.

Aim: To determine the prevalence of body image accuracy/distortion in Brazilian men and women and to investigate sociodemographic and lifestyle-related factors, and the presence of chronic diseases associated with body image distortion.

Methods: Data from 6,357 men and 7,657 women participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were collected using a multidimensional questionnaire covering sociodemographic characteristics, health behaviors, heath conditions and body image perception.

Results: Most participants (53.5% of the women and 54.7% of the men) were found to have an accurate self-perception of their body. When the factors associated with the perception of being heavier than reality were investigated, adopting weight loss measures and not being hypertensive proved protective against this distortion, both in women and men. Conversely, the perception of being lighter than reality was associated, in both women and men, with better education, being black or of mixed race, adopting weight loss measures and not being hypertensive or diabetic. Additional factors associated with underestimating weight were not consuming alcohol (only in women) and belonging to a lower social class (only in men).

Conclusion: These findings may contribute to the implementation of public health policies and interventions to promote health and well-being in the Brazilian population.

Aim: Handwashing with soap remains the single most cost-effective strategy for reducing the spread of infectious diseases. From our scoping search, no study was identified which examined the predictors of children's handwashing behaviour within the context of the Health Belief Model (HBM) and Theory of Planned Behaviour (TPB) combined. This paper contributes to bridging this gap in literature. We sought to examine variables emanating from the HBM and TPB which could potentially predict handwashing behaviour; determine whether behavioural intention will potentially predict behaviour; and identify school children's motivation for proper handwashing behaviour.

Subject and methods: Data were collected from 717 school children recruited from four basic schools. A structured questionnaire was used for data collection. Data were analysed using multi-variable linear regression models.

Results: Participants' knowledge of hand hygiene failed to predict behavioural intention and handwashing behaviour. As regards participants' perception of severity, there was an association with behavioural intention in a crude model, but this was not so in an adjusted model. Also, perception of severity was not associated with handwashing behaviour. Attitude to handwashing (β = 0.120, 95% CI [0.00, 0.24] p = 0.046), possession of handwashing skills (β = 0.037, 95% CI [0.01, 0.07] p = 0.008), and subjective norms (β = 0.263, 95% CI [0.20, 0.33] p < 0.001) were among the psychosocial variables that showed potential for predicting both behavioural intention and behaviour. The TPB's intention-behaviour relationship was corroborated by our results. Among others, motivation for adherence to proper handwashing behaviour included the desire to make hands smell better.

Conclusion: Interventions targeting the handwashing behaviour of school children should consider strategies that move beyond mere knowledge improvement, but rather target attitude and skill enhancement strategies implemented in partnership with 'significant others' such as teachers, and adult peers.

Objective: To examine associations between sleep disturbance, social support, and social comparison among midlife and older adults, including the moderating role of gender.

Methods: Adults ages ≥40 years (N = 557, MAge = 57, 53% men) completed a cross-sectional survey including validated measures of sleep disturbance, perceptions of social support, and social comparison orientation.

Results: Sleep disturbance was negatively associated with social support (rs = -0.42 to - 0.33, ps = 0.001) and associations were stronger for men than women - particularly perceived support from friends (η ² = 0.01). Sleep disturbance was also associated with upward comparison orientation (r = 0.12, p = 0.003), more strongly for women than men (η ² = 0.01).

Discussion: Findings indicate that perceived support from friends (for men) and upward comparison (for women) may have particular influence on sleep among midlife and older adults. Additional work is needed to clarify the nature of these associations and their mechanism(s) of action, to inform potential treatment adaptations for this population.

Background: Lifestyle interventions can promote improvement in dietary intake and physical activity (PA), on average, by strengthening motivation, self-regulatory efforts, and commitment to behavioral change. However, maintenance of behavioral change is challenging, and slow responders during treatment often experience less overall success. Adaptive intervention sequences tailored to treatment response may be more effective in sustaining behavioral change.

Methods: Adults ≥ 21 years old with prediabetes (n = 187) were stratified at week five to the standard Group Lifestyle Balance (GLB) intervention, if they achieved > 2.5% weight loss, or to the augmented intervention GLB Plus (GLB+) at week five, if they did not. At month five, each person in a matched pair was randomly assigned to GLB or GLB + for the extended intervention phase (months 5-12) followed by no study conduct (months 13-18). The primary comparison of interest was the change in outcomes between the standard (GLB followed by GLB) and augmented (GLB + followed by GLB+) intervention sequences post-intervention at 12 - and 18-months using linear mixed effect models.

Results: The augmented GLB + intervention sequence reported a decline in the change in self-efficacy for reducing fat intake, self-efficacy for 'sticking to' healthy eating and exercise, and hopeful thought and planning compared to the standard GLB intervention sequence (all P < 0.0167) at 18-months. However, there were no significant differences between these intervention sequences at 18-months in the change in dietary intake or minutes of PA (all P > 0.05).

Conclusions: No significant change in behavioral measures across intervention sequences occurred at study end. An 18-month decline in self-efficacy regarding diet and PA and hopeful thought and planning among slow responders following no intervention for six months indicates greater extended care is likely needed. The type of extended care that is most effective for slow treatment responders requires additional research.

Background: Endometriosis, a systemic chronic inflammatory condition which has no cure, has a high symptom burden that can negatively impact every facet of life. Given the absence of a gold-standard treatment, the best symptom management regimen in endometriosis is heavily reliant on a patient's values and preferences, making shared decision-making (SDM) vital. However, a comprehensive patient decision aid (PtDA) intervention that could facilitate patient decision-making and promote SDM is lacking in endometriosis, and there is little research on the decisional support needs of individuals with this condition. This qualitative study aimed to explore healthcare professional (HP) perspectives of their clients' decisional support needs when choosing treatments to manage endometriosis symptoms, with a view to evaluating the need for a PtDA.

Methods: Australian HPs identified as specialising in endometriosis care (N = 13) were invited to participate in a short interview over the Internet by phone. Questions focussed on perceived facilitators and challenges of decision-making when choosing treatments for endometriosis. Transcribed qualitative data were thematically analysed and verified by multiple coders, using the template approach.

Results: Four themes were identified: (1) Identifying and setting priorities; (2) HPs' lack of time and perceived lack of knowledge; (3) Patient-centred care and SDM, including patient capacity; and (4) Decision-making blinded by hope. This is the first known study to explore HPs' perspectives on patient decision-making challenges in endometriosis.

Discussion: Findings draw attention to the difficulties people with endometriosis experience when assessing and choosing treatments, highlighting the need for a comprehensive PtDA intervention to support this decision-making.

Background: Receiving hemodialysis treatment makes end-stage renal disease (ESRD) patients highly vulnerable amidst the COVID-19 pandemic. Hence, their kidney disease quality of life (KDQOL) is affected. We aimed to examine the association between fear of COVID-19 (FCoV-19) and KDQOL, and the effect modification of Health literacy (HL) on this association.

Material and methods: A survey was conducted at 8 hospitals from July 2020 to March 2021 on 972 patients. Data collection includes socio-demographic factors, clinical parameters, HL, digital healthy diet literacy (DDL), hemodialysis diet knowledge (HDK), FCoV-19, suspected COVID-19 symptoms (S-COVID-19-S), and KDQOL.

Results: Higher HL scores B = 0.13 (95% CI = 0.06-0.21, p = 0.001) and HDK scores B = 0.58 (95% CI = 0.31-0.85, p = 0.001) were associated with higher KDQOL scores. Whereas, S-COVID-19-S B = -6.12 (95% CI = -7.66 to - 4.58, p = 0.001) and FCoV-19 B = -0.91 (95% CI = -1.03 to - 0.80, p = 0.001) were associated with lower KDQOL scores. Notably, higher HL scores significantly attenuate the negative impact of FCoV-19 on overall KDQOL and the kidney disease component summary.

Conclusions: In hemodialysis patients, FCoV-19 and S-COVID-19-S were associated with a lower KDQOL. Health literacy significantly mitigates the negative impact of FCoV-19 on KDQOL. Strategic public health interventions to improve HL are suggested to protect patient's KDQOL during the pandemic.